CARE JANELLA

Official classification

Type B

Official code

87705(d)

Regulation authority

CCR

What the official deficiency says

87705 Care of Persons with Dementia (d) The licensee shall ensure that the facility has an auditory device or other staff alert feature to monitor exits on exterior doors and perimeter fence gates accessible to those residents who may be at risk for elopement... This requirement is not met evidenced by: Based on observations and interviews, LPA observed four out of five auditory devices were not working: room #4 auditory device was not working, room #2 window auditory device was not in placed, and living area and garage auditory devices were turned off. This poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

Licensee states they will fix bedroom #4 and remove bedroom #2 window auditory device from the room. Licensee states they will ensure all auditory devices are in operation. Proof of Correction evidence will be sent to CCLD via email to Edward.kim@dss.ca.gov by May 9, 2025.

Deadline recorded: May 9, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87303(a)

Regulation authority

CCR

What the official deficiency says

The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation and interview, the licensee did not comply with the section cited above. LPA Observed the faucet on the right side of the outside facility was leaking, the window screen needs to be replaced in Resident#3, and the outdoor gate door on the left side needs to be self-closing and self-latching.This poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 10/29/2024 Plan of Correction Licensee states they will provide proof of fixing the leaky outdoor faucet, replace window screen, and ensure the gate door to be self-closing and self-latching to CCLD via email to edward.kim@dss.ca.gov by POC due date October 29, 2024.

Official classification

Type B

Official code

1569.625(b)(2)

Regulation authority

HSC

What the official deficiency says

(2) In addition to paragraph (1), training requirements shall also include an additional 20 hours annually, eight hours of which shall be dementia care training, as required by subdivision (a) of Section 1569.626, and four hours of which shall be specific to postural supports, restricted health conditions, and hospice care, as required by subdivision (a) of Section 1569.696. This training shall be administered on the job, or in a classroom setting, or both, and may include online training. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, interview, and record review, the licensee did not comply with the section cited above. LPA observed Staff#2 (S2), Staff#3 (S3), and Staff#4(S4) do not have any training available at the time of the inspection visit. This poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 10/25/2024 Plan of Correction Licensee states they will provide proof of completed 2024 training hours for S2, S3, and S4 to CCLD via email to edward.kim@dss.ca.gov by POC due date October 25, 2024.

Official classification

Type B

Official code

1569.695(c)

Regulation authority

HSC

What the official deficiency says

(c) A facility shall conduct a drill at least quarterly for each shift. The type of emergency covered in a drill shall vary from quarter to quarter, taking into account different emergency scenarios. An actual evacuation of residents is not required during a drill. While a facility may provide an opportunity for residents to participate in a drill, it shall not require any resident participation. Documentation of the drills shall include the date, the type of emergency covered by the drill, and the names of staff participating in the drill. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, interview, and record review, the licensee did not comply with the section cited above. LPA observed that the facility did not have a record of emergency drills and administrator stated they did not have any records of emergency quarterly drills. This poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 10/25/2024 Plan of Correction Licensee states they will provide proof of completed emergency disaster drill to CCLD via email to edward.kim@dss.ca.gov by POC due date October 25, 2024.

Official classification

Type A

Official code

87305(b)

Regulation authority

CCR

What the official deficiency says

87305 Alterations to Existing Building or New Facilities (b) The licensing agency may require the facility to acquire a local building inspection where the agency determines that a suspected hazard to health and safety exists. This requirement was not met as evidenced by: Based on LPA's observations and interviews, the addition of the staff bedroom was not cleared by the local fire authority which poses an immediatel Health, Safety, or Personal Rights risk to persons in care.

Official plan of correction

Administrator to submit the LIC200, updated facility sketch, a letter requesting a fire clearance along with $25 check payable to DSS mailed to the Department by POC due date.

Deadline recorded: Sep 1, 2023. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87355(e)(1)

Regulation authority

CCR

What the official deficiency says

87355 Criminal Record Clearance (e) " All individuals subject to a criminal record review...(b) shall prior to working, residing or volunteering in a licensed facility: (1) Obtain a California clearance or a criminal record exemption as required by the Department... " This requirement is not met as evidenced by: Based on observations, interviews, and record review, two out of three individuals, S2 & V1, were not fingerprint cleared prior to working or visitng the facility which poses an immediate Health, Safety, or Personal Rights risk to persons in care.

Official plan of correction

Licensee to provide S2's proof of clearance to LPA via emaill by POC due date and to submit an Acknowlegement of Understanding regarding the said deficiency and for visitors assisting with the operation of the facility without proper clearance.

Deadline recorded: Jul 8, 2023. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87355(e)(2)

Regulation authority

CCR

What the official deficiency says

87355 Criminal Record Clearance (e) " All individuals subject to a criminal record review...(b) shall prior to working, residing or volunteering in a licensed facility: (2) Request a transfer of a criminal record clearance... " This requirement is not met as evidenced by: Based on observations, interviews, and record review, one out of the three individuals, S1, was not associated prior to working at the facility which poses an immediate Health, Safety, or Personal Rights risk to persons in care.

Official plan of correction

Licensee to associate S1 and to provide proof to LPA via email by POC due date and to submit an Acknowlegement of Understanding regarding the said deficiency. S1 was assoicated on today's date.

Deadline recorded: Jul 8, 2023. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87411(g)(2)

Regulation authority

CCR

What the official deficiency says

Personnel Requirements - General (g) Prior to employment or initial presence in the facility, all employees and volunteers subject to a criminal record review shall: (2) Request a transfer of a criminal record clearance as specified in Section 87355(c). This reguirement was not met as evidenced by a unassociated individual present during a visual inspection of the garage are. LPA Haley, the House manager, and Staff 2 observed the unassociated individual in the garage around 11:50AM. This poses an immmediate safety risk to residents in care.

Official plan of correction

Licensee/Administrator, and all staff will read and review regulation sections: 87411 - Personnel Requirements 87355 - Criminal Record Clearance Licensee/Administrator will email LPA Haley a signed statement of understanding that the regulations have been read and understood (signed by all staff). Licensee/Administrator will associate the unidentified individual before they're allowed back into the facility. POC due date: April 27, 2023 at 12 noon.

Deadline recorded: Apr 25, 2023. A deadline is not proof that correction was completed.